MRI Findings and Topographic Distribution of Lesions in Metronidazole-Induced Encephalopathy.

Purpose This study aims to describe the magnetic resonance imaging (MRI) of the brain of five patients diagnosed with metronidazole-induced encephalopathy (MIE). In addition, the aim of our study was to better define the topographic distribution of lesions in MIE. Methods We retrospectively evaluated MRI findings before and after drug cessation in five patients diagnosed with MIE at Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India. The main MRI signal changes and lesion locations were studied. Results Among the patients observed, the average age of the patients with MIE was 55 years (range: 30-70 years). Cerebellar dysfunction, mainly ataxia, and altered mental status were seen in the majority of cases. The most frequently involved sites were the dentate nucleus (cerebellum), brain stem, and corpus callosum (splenium). In diffusion-weighted imaging (DWI), most lesions did not show true restricted diffusion, except for a solitary corpus callosum lesion. Conclusion Although drug-related side effects are more common with long-term use of metronidazole, they may also occur with high doses for short durations. The dentate nucleus, the splenium in the corpus callosum, and the brain stem are the most affected structures. Apart from a solitary lesion of the corpus callosum, all identified lesions were reversible at follow-up MRI after discontinuation of metronidazole. The clinical presentation and characteristic MRI changes are highly specific and can be correlated to make a rapid and more accurate diagnosis of this potentially treatable condition. Prognosis is excellent if detected early.

Association and Correlation Between Amniotic Fluid Index and Glucose Concentration.

PURPOSE: To study the association and correlation between the amniotic fluid index, random glucose concentration, and serum glucose concentration after avoiding oral intake of sugar in a pregnant female with polyhydramnios. METHODS: The research was performed on pregnant women with polyhydramnios (n=104 ) after 28 weeks. USG was performed using a SAMSUNG HS 70A (Samsung Electronics Pvt. Ltd., Seoul, South Korea) and a GE Voluson P8 (GE Healthcare, Little Chalfont, UK). We measured amniotic fluid index and took a blood sample for hemoglobin (Hb)A1C, fasting blood glucose, post-prandial and random blood glucose, and also performed a glucose tolerance test in pregnant women. RESULTS: This is a prospective study, all 104 patients that were recruited in this study were pregnant females with polyhydramnios mainly from the urban and rural zone with different age groups (between 21 and 37 years). In our study, we observed that after avoiding oral intake of sugar in pregnant females with polyhydramnios, it was concluded that the amnionic fluid index lies towards the lower side. Polyhydramnios is more common in the urban zone and among older pregnant females. Out of 104 pregnant females with polyhydramnios, 82 were diagnosed with gestational diabetes after 28 weeks. CONCLUSION: In this study, we have concluded that the earliest and most sensitive predictor for gestational diabetes is a rise in the amniotic fluid index which could have been prevented by avoiding oral intake of sugar. Early prediction of gestational diabetes can be made by amniotic fluid index even before glucose concentration. We observed that by reducing oral intake of sugar, the amniotic fluid index drops down in pregnant females.